Generic name: torsemide (oral/injection) (TOR se mide)
Brand name: Demadex, Demadex I.V.
Dosage forms: injectable solution (10 mg/mL); oral tablet (10 mg; 100 mg; 20 mg; 5 mg)
Drug class: Loop diuretics
Torsemide is a loop diuretic (water pill) that is used to treat fluid retention (edema) in people with heart failure, liver disease, or kidney disease.
Torsemide is also used to treat high blood pressure (hypertension). Lowering blood pressure may lower your risk of a stroke or heart attack.
Torsemide may also be used for purposes not listed in this medication guide.
You should not use torsemide if you are allergic to sulfa drugs or if you are unable to urinate.
Before taking this medicine
You should not use torsemide if you are allergic to it, or if:
- you are unable to urinate; or
- you are allergic to an oral diabetes medicine.
Tell your doctor if you have ever had:
- heart disease;
- kidney problems (unless you are taking torsemide for edema related to kidney disease);
- liver problems such as cirrhosis or hepatitis (unless you are taking torsemide for edema related to liver disease);
- an allergy to povidone (sometimes contained in iodine, Betadine); or
- if you are on a low-salt diet.
If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, tell your caregivers that you currently take torsemide.
Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether torsemide will harm an unborn baby. However, having high blood pressure during pregnancy may cause complications such as diabetes or eclampsia (dangerously high blood pressure that can lead to medical problems in both mother and baby). The benefit of treating hypertension may outweigh any risks to the baby.
It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.
Torsemide is not approved for use by anyone younger than 18 years old.
How should I take torsemide?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Torsemide oral is taken by mouth.
Torsemide injection is given as an infusion into a vein. A healthcare provider may teach you how to properly use the medication by yourself. Torsemide injection is given either as a slow infusion over 2 minutes, or as a continuous (around the clock) infusion.
If you have cirrhosis or other liver problems, you may receive your first injection in a hospital or clinic setting to quickly treat any serious side effects.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don't understand all instructions.
Prepare an injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.
You may take torsemide with or without food.
Your blood pressure will need to be checked often, and you may need other medical tests. Your blood and urine may both be tested if you have been vomiting or are dehydrated.
Some things can cause your blood pressure to get too low. This includes vomiting, diarrhea, or heavy sweating. Call your doctor if you are sick with vomiting or diarrhea.
Your condition may be treated with a combination of drugs. Use all medications as directed by your doctor. Do not change your doses or medication schedule without your doctor's advice.
If you have high blood pressure, keep taking torsemide oral even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medicine for the rest of your life.
Store at room temperature away from moisture and heat.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.
Call your doctor for instructions if you miss a dose of torsemide injection.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include dehydration, an electrolyte imbalance (such as low levels of potassium, magnesium, or sodium in your blood), or low blood pressure and fainting.
What should I avoid while taking torsemide?
Avoid becoming overheated or dehydrated during exercise, in hot weather, or by not drinking enough fluids. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.
What are the possible side effects of torsemide
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor right away if you have:
- a light-headed feeling, like you might pass out;
- ringing in your ears, sudden hearing loss;
- kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath;
- low magnesium level--dizziness, irregular heartbeats, feeling jittery, muscle cramps, muscle spasms, cough or choking feeling;
- low potassium level--leg cramps, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling; or
- low sodium level--headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.
Common side effects may include:
- increased urination; or
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect torsemide?
Tell your doctor about all your current medicines. Many drugs can affect torsemide, especially:
- any other diuretic medicine;
- cholestyramine, lithium, phenytoin, probenecid, rifampin, warfarin (Coumadin, Jantoven);
- an intravenous (IV) antibiotic medicine;
- antifungal medicine--fluconazole, miconazole;
- heart or blood pressure medicine--amiodarone, dronedarone, enalapril, irbesartan, lisinopril, losartan, olmesartan, valsartan, and others;
- NSAIDs (nonsteroidal anti-inflammatory drugs)--ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others;
- salicylates--aspirin, Nuprin Backache Caplet, Kaopectate, KneeRelief, Pamprin Cramp Formula, Pepto-Bismol, Tricosal, Trilisate, and others or
- steroid medicine--dexamethasone, oxandrolone, prednisone, and others.
This list is not complete and many other drugs may affect torsemide. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.